Digital Quality Dispatch: July
Astrata, Inc
We make purpose-built, industry-leading, HEDIS?-focused software for health plan quality teams.
Resources for health care leaders on their digital quality journey
July Blog: Lessons learned from the 2023 Prospective HEDIS? Season
Health Plan Medical Record Review teams are making the switch from their hybrid review season to prospective review season, to maximize the number of gaps closed as we head into 2025. ?In this month’s blog we take a look at the 2023 prospective season, what we learned and how health plans can take these learnings to prepare for future success in upcoming seasons.? We include eight specific areas to spend your time and energy to maximize your impact next year.?
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Looks who’s the guest at our next webinar on August 15th!?
Join us for an exclusive webinar with our guest Melissa Newton Smith from the Newton Smith Group. We’ll deep dive into the world of HEDIS ECDS measurement and help you embark on the journey toward digital quality excellence. In this insightful session, you will learn:
1. How to apply a maturity model approach to your Digital Quality transformation.
2. What is on the horizon from regulators and how to stay ahead of the curve.
3. Ways to leverage your Q4 push to set the foundation for digital quality advancements.
4. Roadblocks and Pitfalls in the Digital Quality Journey and how Health Plans can address them.
5. Advocating for the ROI of Digital Quality with your CFO.?
Register soon for the webinar as it’s filling quickly:?
And if you’ve missed any of our previous webinars, you can always access them on demand here:?Webinars On Demand
Chalk Talks – Learn more about Prospective Review with NLP?
Ready to get started on prospective HEDIS medical record review? Spend 8 minutes with Rebecca to?find out the what, why and how of Prospective HEDIS as well as how Astrata's first pass NLP can help you scale your prospective season, and counteract the impact of hybrid method retirement.?
Watch all of the episodes here:
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Meet us at NCQA’s Health Innovation Summit?
The Astrata team will be at the NCQA Health Innovation Summit from? October 31- November 2, at the Gaylord Opryland Resort & Convention Center in Nashville, TN. It’s the highlight of our year and we are excited to be there with a strong contingent of Astratians.
We are thrilled to announce that our CEO Rebecca Jacobson will be a Keynote Speaker and is on the main stage on Day 1 to discuss digital quality with other industry leaders. And as usual, we’ve got exciting product news, as well as great giveaways. So please register and stop by to say hello.?
Good reads??
With so much to choose from this month, we had a hard time selecting the best reads. With ROI of quality measurement popping up in many of our conversations, here are two we think should really grab your attention and arm you with data as you advocate for the importance or your programs at the C-level of your organizations.?
The Business Case for quality: estimating lives saved and harms avoided in a value-based purchasing model?
This paper by Amico et al quantifies the value of improving scores across two measure (colorectal cancer screening and control of blood pressure) in the California Marketplace plans. By moving lower health plans up to the 66th percentile, they show that deaths from hypertension and colorectal cancer would decrease by 7% and 2% respectively.??
Our takeaway: we need to be broaden our approach for evaluating the ROI of quality measurement to include the significant population benefits and reduced medical expenses that result from incentivizing quality measurement and improvement programs.?
Medication Adherence Star Ratings Measures, Health Care Utilization and Cost?
?This interesting study out of Humana by Poonawalla and Chung retrospectively examines the association between missed CMS Star Ratings for medication adherence and health care utilization and costs for patients with diabetes, hypertension, and hyperlipidemia. Over 103K patients were included and were subdivided by the number of measures missed (0-4+) over a three-year period. Not surprisingly, as the number of measures missed increases, so does the number inpatient stays and emergency room visits as well as monthly medical costs.??
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